Frequent Belching and Sleep Disturbances: Gastrointestinal Issues - Gastroenterology and Hepatology

Sudden frequent hiccups and shallow sleep?

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One evening in early September, I suddenly began experiencing frequent belching, which has continued every day since then.
During that time, I did not make any significant changes to my diet, nor did I experience any stressful events, anxiety, or negative emotions.
Belching can occur at any time, such as when getting up (from lying down to sitting or standing), drinking water, after eating, talking, or moving around; sometimes it happens even when I'm not doing much.
I belch less when lying down or lying on my stomach, and I belch less when sitting on the couch or being inactive; I do not belch while sleeping.
The frequency varies, sometimes high and sometimes low, with varying durations, but I have not had a single day without belching.
I do not feel any reflux of stomach acid or liquid into my throat, no esophageal burning sensation, and no stomach pain; my bowel movements are normal.
I have become able to intentionally belch.
Changing my eating habits has not made a difference.
Typically, I belch once or twice every few minutes; during high-frequency times, I belch two to three times a minute, and during low-frequency times, once every several minutes.
I used to have poor eating habits, such as not chewing enough and eating quickly, but I have corrected those habits over the past few months.

The next day, I visited a gastroenterology clinic, and after two months of treatment, I took many medications for gastroesophageal reflux disease (GERD) without significant improvement.
An endoscopy showed no significant issues, only a slight abrasion.
An ultrasound was also normal, but there was indeed more gas present.
In early November, I was referred to a large hospital's gastroenterology department for further testing.
Esophageal pressure testing was normal.
The pH monitoring showed that the frequency of acid exposure was similar to that of the general population, which may explain the lack of significant effect from the antacids, but it roughly coincided with the timing of my belching.
This could indicate that reflux is causing the belching, or that belching is causing reflux (the causality is unknown), and it is also possible that my gastric mucosa is more sensitive.
The large hospital prescribed a two-week course of Dexilant (a PPI), Motilium, and Seroquel, which I took for seven days (half a tablet after each meal), and I took Buspirone for two days (half a tablet after each meal).
After taking the medications for two days, I felt very sleepy and unable to work, so I gradually stopped taking them.
Since then, I have experienced shallow sleep, waking up six to seven times a night after stopping the medication for a week, and gradually reducing to two to three times a night after two weeks.
I also have dreams and have no difficulty falling back asleep (previously, I would sleep through the night and occasionally dream but forget them upon waking).
My naps have also become shallow.

During a follow-up visit, I was prescribed another two months' supply of Dexilant and Motilium, but I have not resumed taking the medications for now.
In early December, I visited a family medicine clinic due to some chest tightness after vaccination, where I mentioned my belching and shallow sleep issues.
The examination revealed some bloating and signs of reflux in my mouth.
In addition to gastric medications, I was prescribed medications to adjust my autonomic nervous system and for anxiety (Nortriptyline and Escitalopram) to help with my sleep issues.
During that week of medication, my sleep improved temporarily, but after stopping the medication, I returned to shallow sleep within two days.

In mid-December, I was referred to another hospital's gastroenterology department, where the doctor speculated that I might be experiencing supragastric belching (a functional issue where gas accumulates in the esophagus and is stimulated to be expelled).
I attempted to take Buspirone again (starting with one before bed and then increasing to after breakfast), along with Motilium, and added Gas-X, adjusting the timing of Dexilant to after dinner (it can be taken or not, as I had stopped the medication for a week before the pH test and did not see a more acidic condition, so this may have limited benefit).
I changed to taking it at night to see if it could improve my interrupted sleep (as belching might bring acid up and wake me), but there has still been no improvement in my shallow sleep.
Currently, my belching and shallow sleep issues remain unresolved, and I would like to ask the doctor what I should do next.

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Mr. C, 30~39 year old female. Ask Date: 2022/12/27